Smoking & Your Health
Background:
 Cigarettes are the predominant form of tobacco abuse in the US.
 1-2 mg of nicotine per cigarette.
 1-½ pack a day smoker (30 cigarettes a day) will get at least 300 hits of nicotine per day.
 Effects of nicotine on the brain are equal to other stimulants like cocaine. Users report a depression or
relaxation effect but that is actually the withdrawal symptoms being relieved by another cigarette.
Effects on the Body:
 Nicotine Effects: Increased HR, BP, Carbon Monoxide, GI Motility, Alertness, Decreased Appetite,
Vasoconstriction, Fine Tremors, Antidiuretic Effect.
 Nicotine Toxicity: Nausea, Abdominal Pain, Diarrhea, Vomiting, Dizziness, Weakness, Confusion,
Decreased Respirations, Seizures, Respiratory Failure, Death.
 Withdrawals: Cravings, Restlessness, Depression, Headache, Hyperirritability, Insomnia, Decreased BP,
HR, Increased appetite.
 Carbon Monoxide Poisoning: Carbon Monoxide attaches to hemoglobin which decreases 02 carrying
ability. In addition the smoker is inhaling less 02 from the air while smoking.
Combined, this created a low 02 environment in the body, increased cardiac
workload, HR, myocardial consumption, and increased risk for ischemia.
 Psychosocial: Physical & Psychosocial Dependence, Decreased Appetite.
 Neurological: Stoke, Headache, Dizziness, Hyperalertness, Fine Tremors.
 Cardiovascular: Increased HR, Vasoconstriction, Hypertension, Coronary Artery Disease, Peripheral
Arterial Disease, DVT, Myocardial Infarction, Angina.
 Respiratory: COPD, Asthma, Bronchitis, Shortness of Breath, Persistent Cough, Excessive Mucous, Upper
Respiratory Infections, Activity Intolerance
 Gastrointestinal: Peptic Ulcer Disease, GERD, Increased Motility.
 Genitourinary: Antidiuretic Effect, Kidney Disease.
 Immune: Immunosuppression.
 Cancers: Mouth, Larynx, Esophageal, Lung, Stomach, Pancreatic, Bladder, Cervical, Prostate.
Evidence Based Practice:
 A brief 3 minute lecture about smoking cessation can be an effective tool for those who smoke.
 Patient motivation improved and likelihood of future quitting improves even if the patient was not
committed to the idea at the time of intervention.
 Smokers who receive advice and assistance report greater health care satisfaction.
 Discuss with every patient that smokes and every time you see the patient.
 Include 5 A’s of smoking cessation counseling:
 ASK about smoking.
 ADVISE to quit.
 ASSESS willingness to quit.
 ASSIST with quitting.
 ARRANGE follow-up.
Obesity & Your Health
Background:
 Mortality rates for patients with BMI > 30 increase by 50%-100% compared to those with normal BMI.
 BMI Formula: Weight (lb) X 705
Height (In) 2
Effects on the Body:
 Psychosocial: Depression, Eating Disorders, Poor self-Esteem, Body Image Disorders, Social Isolation.
 Respiratory: Sleep Apnea, Asthma, Pulmonary Hypertension, Activity Intolerance
 Musculoskeletal: Osteoarthritis, Gout, Chronic Back Pain, Flat Feet, Tibia Vera, Ankle Sprains.
 Cardiovascular: Hyperlipidemia, Right-Sided HF, Left Ventricular Hypertrophy, Coronary Artery
Disease, DVT, Atrial Fibrillation, Hypertension, Venous Stasis, Cardiomyopathy, Sudden Cardiac Death.
 Gastrointestinal: Gallstones, GERD, Non-Alcoholic Fatty Liver Disease.
 Genitourinary: Renal Disease (Due to DM II & Hypertension), Stress Incontinence
 Endocrine: DM II, Insulin Resistance, Precocious Puberty, Menstraul Irregularities, Metabolic Syndrome.
 Cancers: Breast, Cervical, Ovarian, Uterine, Gallbladder, Colorectal, Prostate
Treatments:
 Nutritional Therapy: Restricted calorie diet (1200 calories/day) Eat foods from all food groups. High
protein, High fiber.
 Exercise: 30 to 60 minutes/day x 5 days a week
 Behavior Modification Therapy: Self-monitoring, Journaling, Stimulus control, Rewards. (Those who are
involved with behavior modification are more likely to maintain their weight goals than those who diet or
exercise alone).
 Support Groups: Weight Watchers, Overeaters Anon.
 Drug Therapy: Appetite suppression drugs (Phentermine, Tenuate, Bontril, Didrex).
Evidence Based Practice:
 Surgery: Bariatric Surgery outcomes are generally positive for patients with a BMI greater than 40 who do
not have excessive risks and patients with a BMI greater than 35 that have one or more co-morbidities.
References
Cope, G. (2013). The effect of smoking on the cardiovascular system. British Journal Of Cardiac Nursing, 8(4),
174-178.
Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., Bucher, L., et al, & Camera, I. M. C. (2011). Medical- Surgical
Nursing, assessment and management of clinical problems. (8th ed. ed.). St. Louis, Missouri: Mosby.
Wolters Kluwer Health LWW. (2012, April). Evidence-Based Treatments for Smoking Cessation. Nursing
Center.com. Retrieved September 15, 2013, from http://www.nursingcenter.com.